Order Code RS21202
Updated April 29, 2004
CRS Report for Congress
Received through the CRS Web
Older Americans Act Nutrition Program
Carol O’Shaughnessy
Domestic Social Policy Division
Summary
The elderly nutrition program, authorized under Title III of the Older Americans
Act, provides grants to state agencies on aging to support congregate and home-
delivered meals to persons 60 years and older. The program is designed to address
problems of dietary inadequacy and social isolation among older persons. It is the
largest Older Americans Act program, funded at $714.5 million in FY2004, accounting
for 40% of the act’s funding. The home-delivered nutrition program has grown
dramatically in recent years. From 1980 to 2002, the number of home-delivered meals
served grew by almost 290%, while the number of congregate meals served actually
declined by 18%. The faster growth in home-delivered meals is due to increased growth
in federal funding as well as state actions to meet the needs of frail older persons living
at home.
The 106th Congress approved the Older Americans Act Amendments of 2000 (H.R.
782, P.L. 106-501) extending the act’s authorization of appropriations through FY2005.
The act is scheduled to be reviewed for reauthorization by the 109th Congress.
Introduction
The elderly nutrition program, authorized under Title III of the Older Americans Act,
provides grants to state agencies on aging to support congregate and home-delivered
meals to persons 60 years and older. The program is the largest component of the act,
accounting for 40% of the act’s total FY2004 funding ($714.5 million out of $1.798
billion). The program is designed to address problems of dietary inadequacy and social
isolation among older persons and evolved from demonstration projects first funded in
1968. In 1972, Congress authorized the program as a separate title of the act and, in 1978,
incorporated it into Title III.
Administration, Funding, and Meals Served. The Administration on Aging
(AoA) in the Department of Health and Human Services (DHHS) awards funds for
congregate nutrition services, home-delivered nutrition services, and nutrition services
incentive grants to state agencies on aging. State agencies award nutrition services funds
to 655 area agencies on aging that administer the program in their respective planning and
service areas. Funds for congregate and home-delivered nutrition services are allotted to
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states according to a formula based on each state’s relative share of the population aged
60 and over; however, the law stipulates that no state receive less than it received in
FY2000, and that all states receive a portion of any increase in appropriations over the
FY2000 level. States are required to provide a matching share of 15% in order to receive
funds for congregate and home-delivered nutrition programs. Funds for nutrition services
incentive grants are allotted to states based on each state’s share of total meals served by
the nutrition services program in all states the prior year. There is no matching
requirement for these funds. Through FY2002, funds for nutrition services incentive
grants were awarded to states by the U.S. Department of Agriculture (USDA); in FY2003,
Congress transferred the program to AoA.
In FY2004, of the $714.5 million for the program, $386.4 million is for congregate
nutrition (54%); $179.9 million for home-delivered nutrition (25%); and $148.2 million
for nutrition services incentive grants (21%) (Table 1). Funding for nutrition services
represents nearly 58% of FY2004 funding for Title III, which also funds a wide array of
social services to older persons, family caregiver support activities, and disease prevention
and health promotion services. The home-delivered nutrition program has grown
dramatically in recent years. From 1980 to 2004, funding for home-delivered services
grew by 260%, while funding for congregate nutrition services increased by about 43%.
Table 1. Older Americans Act Nutrition Services Funding,
FY1980 — FY2004
($ in millions)
Nutrition
services
Total
Fiscal
Congregate
Home-Delivered
incentive
nutrition
year
meals
meals
grantsa
services
1980
$270.0
$50.0
$74.2
$394.2
1985
$336.0
$67.9
$127.0
$530.9
1990
$351.9
$79.0
$143.5
$574.4
1995
$375.8
$94.1
$150.0
$619.9
1996
$364.5
$105.3
$150.0
$619.9
1997
$364.5
$105.3
$140.0
$609.9
1998
$374.4
$112.0
$140.0
$626.4
1999
$374.3
$112.0
$140.0
$626.3
2000
$374.3
$147.0
$140.0
$661.3
2001
$378.4
$152.0
$149.7
$680.1
2002
$390.0
$176.5
$149.7
$716.2
2003
$384.6
$181.0
$148.7
$714.3
2004
$386.4
$179.9
$148.2
$714.5
Source: AoA and USDA appropriations legislation.
a. Formerly USDA cash or cash-in-lieu of commodities program.

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Although states receive separate allotments for congregate and home-delivered
nutrition services, and for supportive services, they are allowed to transfer allotted funds
among these three service categories (up to 40% of funds between congregate and home-
delivered nutrition services allotments with waivers for higher amounts if approved by
the Assistant Secretary for Aging; and up to 30% among supportive services and
congregate and home-delivered nutrition services allotments). In recent years, state
transfer of funds has resulted in a decrease of funds available for congregate nutrition
services. In FY2001, states transferred $68 million out of their congregate nutrition
services allotments to either the home-delivered nutrition or supportive services
allotments, resulting in a decrease of 18% in funds that were originally for congregate
nutrition services. Funds available for home-delivered meals increased by 25% as a result
of funding transfers. State initiatives to respond to the demand for home-based services
by frail homebound older persons is an important factor in their decisions to transfer
funds.
In FY2002, of the 250 million meals were provided to older persons, 57% were
provided to frail older persons at home, and 43% were provided in congregate settings
(Table 2). From 1980 to 2002, the number of home-delivered meals served grew by
290%, while the number of congregate meals served actually declined by 18%. A number
of reasons account for this, including the trend by states to transfer funds from their
congregate services allotments to home-delivered services; increased federal funding for
home-delivered services; state initiatives to expand home care services for frail older
persons living at home; and successful leveraging of non-federal funds for home delivered
services.
Table 2. Older Americans Act Nutrition Services,
Number of Meals Served, FY1980 — FY2002
(in millions)
Home-delivered
Fiscal
Congregate
Home-delivered
meals as a percent
year
meals
meals
Total meals
of total meals
1980
132.0
36.4
168.4
22%
1985
149.9
75.5
225.4
33%
1990
142.4
101.8
244.2
42%
1995
123.4
119.0
242.4
49%
1996
118.6
119.0
237.6
52%
1997
116.5
123.5
240.0
51%
1998
114.0
130.0
244.0
53%
1999
112.8
134.6
247.4
54%
2000
115.9
143.5
259.4
55%
2001
112.1
143.5
255.6
56%
2002
108.3
142.0
250.3
57%
Source: Administration on Aging, State Program Reports.

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Eligibility and Service Delivery Requirements. Persons aged 60 or older and
their spouses of any age may participate. The following groups may also receive meals:
persons under age 60 with disabilities who reside in housing facilities occupied primarily
by the elderly where congregate meals are served; persons with disabilities who reside at
home with, and accompany, older persons to meals; and nutrition service volunteers.
Services must be targeted at persons with the greatest social and economic need, with
particular attention to low income minority older persons and older persons residing in
rural areas. Means tests for program participation are prohibited, but older persons are
encouraged to contribute towards the costs of meals. They may not be denied services for
failure to contribute.
Congregate and home-delivered nutrition services projects are required to offer at
least one meal per day, five or more days per week (except in rural areas where less
frequency is allowed). Each meal must provide a minimum of one-third of the daily
recommended dietary allowances established by the Food and Nutrition Board of the
National Academy of Sciences-National Research Council.
Providers must provide meals that comply with state or local laws regarding safe and
sanitary handling of food, equipment, and supplies that are used to store, prepare and
deliver meals, and must carry out meal programs using the advice of dietitians and meal
participants. The law requires projects to provide for nutrition screening of participants,
and where appropriate, nutrition education and counseling. Providers are encouraged to
make arrangements with schools and other facilities serving meals to children in order to
promote intergenerational meals programs.
Congregate meals programs operate in a variety of sites, such as senior centers,
community centers, schools, and adult day care centers. Nutrition service providers offer
a variety of social services at meal sites, such as nutrition education and screening,
shopping assistance, and health promotion activities.
Program Evaluation. In June 1996, AoA released findings of a major national
evaluation required by the 1992 amendments. The evaluation, Serving Elders At Risk:
The Older Americans Act Nutrition Programs, reported that the program is an important
part of participants’ overall nutrition. OAA supported meals consumed by participants
are their primary source of daily nutrients. Participants are older and more likely to live
alone, to be poor, and to be members of minority groups compared to the total elderly
population. They are also more likely to have health and functional limitations that place
them at nutritional risk. The evaluation also indicated that for every Title III dollar spent,
the program leveraged between $1.70 (for congregate meals) to $3.35 (for home-delivered
meals) in other funding sources, including state, local and private funds, and participant
contributions toward the cost of meals.1
1 Administration on Aging, Serving Elders at Risk: The Older Americans Act Nutrition Programs
— National Evaluation of the Elderly Nutrition Program, 1993-1995.

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Legislation. P.L. 106-501 reauthorized the Older Americans Act Amendments
through FY2005. The act is scheduled to be reviewed for reauthorization by the 109th
Congress. Among other things, the 2000 amendments clarified that the Title III formula
used for allocation of nutrition services funds to states should be based on the most recent
U.S. Census Bureau data on the number of persons 60 and over. It also stipulated that no
state receive less than it received in FY2000. In addition, Congress wanted to assure that
if there were an increase in appropriations over the FY2000 level, each state would
receive a share of the increase; the law required that each state allotment be increased at
a rate that is at least 20% of the percentage increase in the total allotment over the
FY2000 amount.
P.L. 106-501 also changed the formula for distribution of nutrition service grant
funds. The formula for this program (formerly known as the USDA cash or cash-in-lieu
of commodities program) was changed from one that was based on per meal
reimbursement rate set by law and updated each year by the Secretary of Agriculture.
Funds are now distributed to states based on each state’s share of the number of meals
served under its nutrition program the prior year. In FY2003, appropriations legislation
transferred the program from the USDA to AoA, and stipulated that these funds may not
be subject to transfer provisions that apply to Title III supportive services; may not be
used for state and area agency administration; and are not subject to the federal matching
requirements that apply to the congregate and home-delivered nutrition programs. In
addition, as under prior law, states may continue to receive reimbursement in the form of
cash (as most states do) or commodities in lieu of cash.

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